Register to Vote: Rock the Vote, powered by Credo Mobile

HOME

ABOUT US

OUR ISSUES

Information & Access

Nonprofit Advocacy

Regulatory Policy


PRESS ROOM

ACTION CENTER

PUBLICATIONS

THE WATCHER

OUR BLOGS


SIGN UP

Receive news, updates, and alerts!

DONATE

Help support our work


OTHER SITES

FedSpending.org

RTK NET

NPAction

Working Group on Community Right-to-Know

Citizens for Sensible Safeguards

Open the Government

OMB Watch Logo

Demanding a federal budget that is fair, responsible, and meets our nation's priorities

Home :  Federal Budget & Tax : 
Federal Budget & Tax:      News     Blog     Background    



Friday, November 30, 2007

Today's Krugman Column Needs Work

Paul Krugman's column today was a little off-base, I think. He basically calls out Sen. Barack Obama for not including a mandate in his universal health care plan, which he thinks will make insurance much cheaper.

I think his claims are overblown. The best estimate I've seen puts health care cost overruns at $480 billion. About $100 billion was due to inefficiencies in the insurance system on its own, and administrative expenses and profits make up the bulk of those unnecessary expenses. And I haven't seen anything on how being uninsured significantly raises costs in the delivery system.

Inadequate risk-pooling seems less a source of waste than just a more equitable way to finance health care. It could bring down costs for some people, but the main reason health care is so expensive for everyone isn't that we don't have universal health insurance, per se- it's that health care purchases aren't being effectively managed. The fact of the matter is that no candidate for president I'm aware of has accepted this and proposed to address it head on.

Krugman cited CBO director Peter Orszag's work on health care in an excellent recent column about Social Security. Orszag has been on the warpath describing what's really going on in the health care system, as best people know. Krugman should read Orszag's work more carefully.



Posted by Matt Lewis, 12:02:08 PM



Wednesday, November 28, 2007

Not Changing the Food Stamp Program Is A Budget Cut

The Center on Budget and Policy Priorities has another important fact sheet up, this time on the Food Stamp program. Congress is considering leaving the program, which is up for reauthorization in the Farm Bill, unchanged. Work on the Farm Bill in the Senate has ground to a halt, and some folks in Congress are suggesting that they revisit the program the next time it comes up for reauthorization- 5 years from now.

But as the paper makes clear, the increasing price of food, and eroding value of food stamp benefits, will make a straight reauthorization equivalent to a budget cut. In addition, a straight reauthorization would fail to address the emergency food crisis facing food banks and their clients, since the House-passed changes to The Emergency Food Assistance Program would be taken out of the bill, too.

This is infuriating. Like the SCHIP funding increase, whether you support this bill or not is more or less a test of whether you're a human being. Well, maybe that's going a little too far, but they could have picked some other bills to make their precious political statements, but they didn't, because they think they can get away with picking on low and moderate-income people. Hold them accountable!



Posted by Matt Lewis, 04:00:54 PM



Columnists Fight Over Social Security

The Washington Post's Ruth Marcus has a column today on Social Security and fixing it.

The column's more or less in response to this Paul Krugman column where he objects to addressing Social Security's projected shortfall now.

If Marcus believes Social Security needs fixing, fine. But she should then devote far more columns to projected health care costs, which is an even bigger problem and demands greater effort to solve it, yet policymakers aren't really paying attention to it. This is what CBO basically recommends.



Posted by Matt Lewis, 10:00:05 AM



Tuesday, November 27, 2007

Giving Up On SCHIP?

CQ (no subscription) is reporting that health care advocates are abandoning the SCHIP funding increase and asking for a one-year extension that maintains the level of service being offered now. Some states may not have enough money to provide insurance to everyone enrolled now if Congress doesn't do something soon.

When you're faced with a choice between the President's request to cut SCHIP and a one-year extension, I can understand choosing the latter. The question is, has it come to that? Bush and the Republicans do seem so stubborn that there's no chance of a reasonable compromise, and I doubt the Democrats will outfox them.



Posted by Matt Lewis, 03:30:02 PM



CMS Releases Plan To Make Medicare Payments More Efficient

The Center on Medicaid and Medicare Services (CMS), an agency in the US Department of Health and Human Services, just released a plan to make Medicare's payments to hospitals more efficient. This plan, which needs authorization from Congress to be implemented, would address one aspect of the rise in health care costs, the main driver of the long-term budget shortfall and most likely the biggest source of governmental waste now.

This plan seems to have potential, and I'd leave it to the government performance experts to evaluate it properly. It's limited mostly by design, because it would only impact payments to hospitals and seems to put less emphasis on letting people know about the comparative effectiveness of different treatments. More comprehensive plans are probably needed for all parts of the system.



Posted by Matt Lewis, 11:31:57 AM



Monday, November 19, 2007

Social Security: Where the Fire?
Candidates Cling to the Third Rail

Maybe they think it will get them attention. Why else would presidential candidates as diverse as John Edwards and Fred Thompson raise the issue of Social Security, a program that almost no one among budget policy experts seriously believes is in imminent trouble?

In "Edwards, Thompson Say U.S. Must Ward Off Crisis in Social Security Funding," Bloomberg.com reports the latest alarm sounded on the issue:

On CNN's Late Edition, John Edwards declared, "Social Security is an enormous issue facing this country" and recommended some tax hikes "in order to keep Social Security solvent in the future."

Thompson said on ABC's This Week yesterday that "the country can't afford to 'let the bottom fall out' from the program in the next three decades."

The Social Security Trustees' most recent report indicates that program is guaranteed to remain solvent for the next 34 years even if no change is made to it.

For a thorough and sober-minded critique of the "general Washington political discussion of Social Security," see: A Taxing Matter.



Posted by Dana Chasin, 06:54:14 PM



Friday, November 16, 2007

Whatever Happened to SCHIP and the Farm Bill?

CongressDaily ($) is reporting that the two reauthorizations that have funding increases for human needs programs -the Farm Bill and SCHIP- aren't going anywhere anytime soon. Negotiations over SCHIP have broken down, and the Senate failed to close off debate on the Farm Bill. We'll have to wait until after Thanksgiving to try again.

This is all pretty demoralizing, particularly given the yesterday's failed vote to override the Labor/HHS veto. Keep in mind that Bush's strategy is in part to demoralize us. It titillates the conservative base when a progressive agenda is frustrated, particularly on spending and tax issues. But nobody else is amused. The American public is by all measures I've seen behind these spending proposals and furious with the President and his supporters for opposing them.

P.S. This could make you feel better- the Coalition on Human Needs wants you to hold your representative accountable for their votes on Labor/HHS.



Posted by Matt Lewis, 05:10:10 PM



Review of Books On Health Care Costs

A good article on health care cost issues from the American Prospect.

It's a review of three new books on health care that are broadening the debate over health care costs outside the context of the long-term fiscal challenge. For years health care policy people have focused on insurance as a cure for all that ails the health care system, overlooking the cost-inefficiencies of the delivery system. Only recently has there been a good discussion. This discussion is now having a spill-over affect on fiscal policy, which is pretty awesome.



Posted by Matt Lewis, 02:01:02 PM



Wednesday, November 14, 2007

CBO's Health Care Projections

CBO just released an impressive document on health care costs and long-term fiscal issues. It includes:

  • A more realistic projection of health care costs, absent changes in federal law
  • The relative importance of an aging population, health care costs, and social security costs
  • A systematic explanation of the rise in health care costs and its value
  • A discussion of possible remedies to excess health care costs

It's encouraging that CBO's examination of health care costs is becoming more sophisticated and detailed. They have clearly shifted a considerable amount of resources into studying health care, and hopefully the think tanks, policy experts and lawmakers who control the debate over long-term fiscal issues will do likewise. Addressing health care costs, after all, is much more important than addressing forecasted shortfalls in Social Security.



Posted by Matt Lewis, 11:44:59 AM



Wednesday, November 07, 2007

The Inherent Superiority of the Private Sector

Businesses are moving on ideas to incentize better quality and cost-efficient health care. Why is it taking so long for government to do the same?

It's not because of red tape and agency capture and the like. There are at least two conceptual straight jackets holding back reform. 1. The enlightened statesman's view that the "entitlement crisis" is one of demographics and overusage and that it has nothing to do with market inefficiencies in the health care delivery system. And 2. the related, but distinct, belief held by conservative ideologues that the market can do no wrong, and that if there's an efficiency problem, it's probably a "moral hazard" issue caused by government interference.

CBO's Peter Orszag is changing the elite discourse on long-term fiscal issues, so help may be coming. A big thanks to the private sector for leading the way, though.



Posted by Matt Lewis, 06:06:55 PM



Leave Social Security Be

Paul Starr explains why it's a bad idea to tinker with Social Security now- even if the solution is to raise the payroll tax.



Posted by Matt Lewis, 01:35:21 PM



Monday, November 05, 2007

SCHIP Is About Politics

The NYT a pretty interesting article on the politics behind SCHIP, but it has big problems. First, the article makes it pretty clear that the President decided to veto this bill regardless of what was in it. He has never tried to work with the bill's designers to come up with an acceptable compromise. The veto is entirely his decision and his fault. So why then is the headline "Missteps on Both Sides Led to Health Bill Veto?"

Now, who's fault is it that the veto wasn't overridden?

Missteps by each side made compromise impossible. Democrats say that Mr. Bush described the bill in wildly inaccurate terms, got bad advice from his staff and missed many opportunities to find common ground. Republicans say that Democrats misjudged the president; excluded House Republicans, who in the end were crucial, from negotiations; and aimed negative advertisements at the very members whose votes they needed to override a veto.

Perhaps that's true enough, but it's wrong to interpret the calculated decision to try to block SCHIP as resulting from someone's "missteps." The Administration and many House Republicans essentially don't want the SCHIP reauthorization to be enacted. They nearly admitted as much when they declared victory once their veto was sustained, and when Bush said that the whole veto push was mostly about him retaining political strength.

A more plausible explanation for the deadlock is that most conservatives, and even some hyper-partisan liberals, aren't interested in meaningful compromise. SCHIP has become the object of a major political fight, and it's incredible that the article would explain the failure to enact it as some kind of tragedy of errors.



Posted by Matt Lewis, 11:39:58 AM



Friday, November 02, 2007

Senate Approves Revised SCHIP Bill

Last night, the Senate passed the latest version of the SCHIP package. The 65-30 vote (roll call is veto-proof, because enough Senators who didn't vote are reliable "yea" votes.

Since the bill did not receive a veto-proof majority in the House, Congressional leaders may decide to not send the bill to the President. Instead, Senate and House negotiators appear to be working hard on a new compromise bill that could be voted on as early as next week.

It ain't over, folks. We're crossing our fingers that the negotiators will come up with a compromise that's acceptable to both current supporters and the few opponents who're still on the fence. Families USA is holding firm on the goal of insuring 10 million children.



Posted by Matt Lewis, 11:12:33 AM



Thursday, November 01, 2007

One If By Legislation, Two If By Regulation

The House Committe on Oversight and Government Reform had a hearing today on the Bush administration's backdoor Medicaid cuts. Extremely loyal BudgetBlog readers may recall that the Administration has been pushing for rules that would cut Medicaid ever since the same cuts were rejected by the last (Republican-controlled!) Congress. I guess they haven't given up.

The Administration is claiming that the rules will cut down on bad claims on Medicaid. Not so, says Chairman Waxman.

But let's also be clear: these regulations are not about program integrity. If they were, CMS would be refining guidance and improving accountability. Instead they seek to prohibit services that have been successful for decades and cut funding that the Congress has specifically preserved. This is not careful surgery on Medicaid; this is reckless amputation.

Furthermore, the Administration has enacted SCHIP regulations that could in effect cut children off child health insurance rolls. What's next, age ceilings for Medicare beneficiaries?



Posted by Matt Lewis, 05:09:20 PM




Latest Entries by Theme

All Themes

Appropriations & Spending

Federal Tax Policy

Income/Wealth Inequality

Budget Projections

Government Performance

Estate Tax

State Fiscal Policy

Watcher

Entitlements

Budget Process

Debt & Deficit

Oversight & Enforcement

Transparency

Privatization

Contact Us

Most Recent Entries for Federal Budget & Tax

Bush Signs War Supplemental

BudgetBlog on Hiatus for Holiday: Happy Fourth Everyone!

The Heat Must Be Getting to Them

GAO Report Finds Private Medicare Providers Prefer Profits Over Providing Better Service

Yet Another Example of Questionable Outsourcing

Senate GOP Battling Themselves Over Earmarks

More Support for Ending the Contracting Free-For-All

House Approves Fiscally-Responsible AMT Patch

Contracting Oversight Commission Members Announced

OMB Refuses to Prioritize Army Contractor Oversight

Archived Entries for Entitlements

June

May

April

March

February

January

December, 2007

November, 2007

October, 2007

September, 2007

August, 2007

July, 2007

June, 2007

May, 2007

April, 2007

March, 2007

February, 2007

January, 2007

December, 2006

November, 2006

October, 2006

August, 2006

June, 2006

February, 2006

November, 2005

October, 2005

September, 2005

August, 2005

July, 2005

June, 2005

May, 2005

April, 2005

March, 2005

February, 2005

January, 2005

December, 2004

November, 2004

August, 2003